UE testing Flashcards
1
Q
sharp-purser test
A
- pt neck flexed - causes symptoms
- PT palm on forehead, thumb and forefinger on axis SP, posteriorly translate head
- assesses transverse ligament - stabilizer of dens on atlas
- (+) reduction in symptoms, click/clunk felt
2
Q
alar ligament stress test
A
- pt head in PT hand, other hand pincer grasp C2 SP
- sidebend pt head to right and feel for left TP to come into fingers
- (+) significant side bending with empty end feel, TP does not come into fingers
3
Q
cervical radiculopathy
A
- < 60 degrees rotation to involved side
- (+) spurling’s - pressure through C spin
- (+) distraction test
- (+) median nerve
4
Q
cervical flexion rotation test
A
- pt flexes C spine to end range
- PT stabilizes head and uses hands to rotate to end range
- for upper C spine ROM - C1-C2
- (+) is symptom reproduction or difference of 10 degrees in one direction
5
Q
UE dermatomes and myotomes
A
- dermatomes
- C4: posterior lower neck, clavicle
- C5: deltoid
- C6: thumb
- C7: middle finger
- C8: pinky
- T1: medial forearm
- myotomes
- C1/2: neck flexion
- C3: neck side bending
- C4: shoulder elevation
- C5: shoulder abduction
- C6: elbow flexion, wrist extension
- C7: elbow extension, wrist flexion
- C8: thumbs up (APB/EPL)
- T1: finger abd.add
6
Q
special tests for TOS
A
- cervical rotation lateral flexion - 1st rib
- ROOS (east) test
- cyriax release test/passive scapular elevation
- hyperabduction test
- costoclavicular test
- adson’s test
7
Q
Roos test
A
- pt abducts shoulders to 90, elbows flexed to 90, ER shoulders 90 - field goal arms
- open and close fists through full range as quickly as possible for 3 (?) minutes
- positive is increase in symptoms, sensation of heaviness or tingling
8
Q
passive scapular elevation
cyriax release test
A
- grab under pt forearms and support wrists
- fully elevate pt shoulders and have them lean back 15 degrees
- hold 1 minute
- (+) reproduction of symptoms by unloading vascular bundle, causing numbness, tingling, cold, hot, fatigue
9
Q
hyperabduction test
A
- TOS
- find pt radial pulse and passively abduct shoulder through complete range and ER arm
- hold 1 minute
- (+) is abolishment or decreased radial pulse or increase in symptoms
10
Q
costoclavicular test
A
- for TOS between clavicle and first rib
- palpate radial pulse
- pt retracts and depresses scapula as much as possible while arm into extension and slight abduction
- hold 1 minute
- (+) decrease in radial pulse or increase in symptoms
11
Q
adson’s test
A
- for TOS scalene entrapment
- palpate radial pulse and passively abduct, extend, ER arm
- pt takes deep breath and rotates head ipsilaterally
- (+) abolishment or decreased radial pulse
12
Q
brachial plexus test
A
- TOS vs BP parasthesias
- palpate upper trapezius and inferior portion of anterior scalene with thumb
- squeeze 30 seconds and assess for symptoms
- assess opposite side
- (+) reproduction of parasthesias
13
Q
shoulder arc of pain
A
- usually 75-120 - can be flexion, abduction, or scaption/elevation
- subacromial pain syndrome
14
Q
neer test
A
- subacromial pain syndrome
- start with least aggressive version enecessary to reproduce pain
- PASSIVE: block scapula, neutral rotation, full scaption
- (+) if reproduces familiar pain
15
Q
hawkins-kennedy
A
- hawkins impingment test - subacromial pain syndrome
- scaption/elevation position for subacromial impingement - bursa, supraspinatus
- flexed and horizontally adducted for coracoid impingement - biceps against coracoid
16
Q
empty can/full can
A
- rotator cuff
- suprapsinatus
- 90 degrees elevation and full IR for empty can
- 90 degrees elevation and neutral rotation for empty can
- if EC is painful but full can is not, likely subacromial or bursa
17
Q
champagne toast test
A
- rotator cuff - supraspinatus
- less deltoid and no impingement like EC/FC
- 30-40 degrees of flexion and abd, slight ER, elbow 80-90 degrees flexion
- PT attempt to push humerus back to neutral (Adduction and extension)
18
Q
resisted ER at side
A
- can be subacromial
- at 45 degrees abduction - infraspinatus
19
Q
speed’s test
A
- biceps tendinopathy
- pt shoulder felxed to 90, palm up (ER), slight bend in elbow
- resistance to distal forearm while palpating biceps tendon - reproduction of symptoms at biceps tendon
20
Q
yergason’s test
A
- LHB pain
- elbow by side, flexed to 90
- pt supinates arm against PT resistance
- (+) reproduction of symptoms
21
Q
drop arm
A
- supraspinatus
- test: straight arm in abduction
- sign: bent elbow in scaption
- pt arm passively to 90 degrees
- (+) unable to hold position or slowly lowers involved arm with control
- straight down - supraspinatus
- hand in/horn blower - infraspinatus
22
Q
external rotation lag sign
A
- infraspinatus, teres minor
- passively flex pt elbow to 90, abduct shoulder 20 degrees, max ER
- pt asked to maintain position
- (+) if fall into IR
23
Q
belly press test
A
- subscapularis
- pt involved hand on belly, tries to push palm into belly
- (+) if pt flexes at wrist, uses shoulder ext/add to push into belly
24
Q
internal lag sign
A
- subscapularis - also need good shoulder IR
- pt hand behind back like functional IR
- pt asked to lift/hold arm off back
- (+) pt unable to maintain arm off back
25
Q
load and shift
A
- MDI
- stabilize clavicle and scapula
- gently load humerus - push into glenoid
- glide humeral head ant and post
- note amount of translation and end feel
- (+) is movement (not pain)
26
Q
sulcus sign
A
- MDI
- stabilize scapula by holding acromion
- pull downward on distal humerus to produce inferior traction force on GH joint
- (+) is depression between acromion and humeral head
- 1+ is < 1 cm
- 2+ is 1-2 cm
- 3+ is > 2 cm
27
Q
hyperabduction
A
- MDI
- stabilize scapula, pt arm passively abducted - elbow flexed to 90, forearm parallel to floor
- > 110 degrees is lengthening/laxity of IGHL and positive in 85% with instability
28
Q
load and shift in supine
A
- for return to sport with labral tear or repair
- pt supine, arm 90/90
- grasp proimal humerus with inside hand and distal humerus with outside hand
- stabilize distal humerus and shift proximal ant/post in plane of scapula/glenoid
- the crazy david james one
29
Q
apprehension test
A
- anterior GH, bankart lesion
- pt supine, arm 90/90
- shoulder progressively ER - passively
- (+) pt reports pain or apprehension
- relocation - same test but posterior pressure applied at proximal humerus
30
Q
jerk test
A
- posterior, 7-11 tears
- axial force applied to arm in 90 degrees abduction and IR
- pt arm horizontally adducted (scaption to midline) - maintain axial load
- (+) sharp pain with click/clunk
- can also be infraspinatus if other infrapsinatus involvement
31
Q
kim test
A
- posterior, 6-9
- axial force applied to arm in 90 degrees abduction
- arm elevated 45 degrees diagonally upward with backward force applied at proximal humerus
- (+) posterior shoulder pain with click
32
Q
o’briens
A
- activate compression test
- SLAP tear
- pt shoulder flex to 90, elbows extended
- first full IR, adduction - backs of hands together and resist downward force on arms
- then full supination - resist downward force again
- deep pain - biceps labral complex
- over AC joint - AC joint pathology
- posterior shoulder pain - SLAP
- anterior shoulder pain - LHB
- (+) if pain eleicited with first and eliminated with second
- if both painful, subacromial
33
Q
modified dynamic sheer test
A
- SLAP
- pt seated
- pt shoulder put into 120 abd and max ER w/ elbow at 90
- palpate post joint line and lower 120 -> 60
- max ER, 30-60 abd, axial load
- (+) painful click
34
Q
biceps load II
A
- SLAP
- abduct pt (supine or seated) shoulder to 120, flex elbow to 90
- resist patient elbow flexion
- (+) deep shoulder pain
35
Q
resisted supination with ER
A
- SLAP
- pt supine
- passively abduct arm to 90 degrees
- pt tries to supinate against resisted force - fires biceps
- passively ER shoulder
- (+) reproduction of symptoms, clicking, popping
36
Q
LHB intra-articular tendon pathology
A
- throwers/overhead sports
- presents like SLAP
- active compression/o’briens
- thrower’s test
- palpation within proximal groove
37
Q
crossbody adduction test
A
- pt shoulder passively flexed to 90 and adducted across pt body
- (+) pn at AC joint
38
Q
resisted extension/horizontal abduction
A
- pt horizontally abducts arm against resistance
- (+) pn in AC joint
39
Q
cozen’s test
A
- for lateratal epicondylalgia
- pt elbow in full extension
- PT thumb over lateral epicondyle
- wrist into extension with hand in fist
- slight pronation with radial deviation
- try to move pt out of position
- (+) reproduction of symptoms
40
Q
mill’s test
A
- lateral epicondylalgia
- shoulder in 70 degrees abd, 90 degrees flexion
- thumb inside fist
- flex and ulnarly deviate hand
- extend elbow slowly
41
Q
third finger test
A
- lateral epicondylalgia
- PT resists extension of middle finger
42
Q
elbow flexion test
A
- cubital tunnel syndrome
- pt fully flexes elbow with neutral wrist
- maintain position 1-3 minutes or until reproduction of symptoms
43
Q
shoulder IR test
A
- cubital tunnel syndrome
- pt UES 90/90, max IR
- (+) if any symptoms within 10 seconds
44
Q
froment’s sign
A
- cubital tunnel syndrome
- patients grips piece of paper using lateral key grip, PT tugs paper
- normal: pt maintains lateral key grip - adductor pollicis in tact
- (+) change of thumb and forrefinger to “O” - indicates use of flexor pollicis longus
45
Q
wartenburg’s sign
A
- cubital tunnel syndrome
- examiner passively spreads pt fingers apart on table
- patient adducts fingers
- (+) inability to adduct pinky finger
46
Q
tinnel’s sign
A
- cubital tunnel syndrome
- pt supine, field goal arms
- tap ipsilateral cubital tunnel
- (+) reproduction of familiar symptoms
47
Q
PTS test
A
- median nerve - pronator teres syndome
- pt seated
- flex elbow to 90 and passively pronate forearm at wrist
- apply resistance into supination to activate pronator muscle
- pt resists as PT extends elbow
48
Q
pinch grip
ok sign
A
- median nerve - anterior interosseous syndrome
- pt asked to pinch tips of index finger and thumb together to make “Ok” sign
- (+) not tip-to-tip but pad-to-pad, indicates anterior interosseous nerve (branch of median nerve) pathology or compromised AIN
49
Q
elbow valgus stress test
A
- at 0 and 30 degrees of flexion
- apply valgus force
- for UCL
50
Q
moving valgus stress test
elbow
A
- pt seated w/ shoulder 90 degrees abd
- passively apply valgus from extension to flexion
51
Q
varus stress test
elbow
A
- at 0 and 30 degrees
- for radial collateral ligament injury
52
Q
pivot shift apprehension test
elbow
A
- posterolateral instability
- pt supine with arm overhead and palm supinated
- PT standing at head of table - apply axial load, flex elbow, apply valgus stress
- (+) radius/ulna sublux off humerus, sudden clunk of joint at 40-70 degrees flexion
53
Q
biceps squeeze test
A
- bicep rupture
- pt seated w/ arm in lap, elbow flexed 60-80 degrees, slight pronation
- squeeze bicep with both hands
- (+) lack of supination - indicates rupture of biceps brachii tendon
54
Q
biceps hook test
A
- biceps rupture
- pt seated, elbow at 90
- insert tip of index finger under medial or lateral edge of biceps tendon in antecubital fossa
55
Q
motions of the thumb
A
56
Q
thumb ulnar collateral ligament stress test
A
- for tear of UCL
- seated, arm on table, thumb up
- take pt thumb to full extension
- apply valgus stress to UCL
- (+) more than 30-35 degrees movement
57
Q
first CMC grind test
A
- for OA
- seated, arm on table, thumb up
- follow MC down to CMC joint line and grind joint
- (+) reproduction of symptoms
58
Q
watson’s scaphoid shift
A
- scapholunate instability
- seated arm on table
- place pt hand in extension and ulnar deviation
- palpate scaphoid
- passively move hand into radial deviation and release scaphoid
- (+) palpable/audible clunk or pain
59
Q
carpal bones
A
- scaphoid, lunate, triquetrum, pisiform
- trapezium, trapezoid, capitate, hamate
- “um odd”
60
Q
finklestein test (eichoff’s)
A
- dequervain’s tenosynovitis
- seated, hands in fist w/ thumb inside fingers
- stabilize forearm and deviate wrist in ulnar direction
- (+) reproduction of pain of APL and EPB
61
Q
WHAT test
A
- dequervain’s tenosynovitis
- seated, arm on table, wrist flexed, fingers to floor
- stabilize hand
- pt thumb into radial adduction against PT pressure - resist adductuction
- (+) reproduction of pain
APL and EPB
62
Q
tinel’s
carpal tunnel syndrome
A
- CTS - median nerve
- pt seated, arm on table, palm up
- support pt hand in neutral wrist
- tap carpal tunnel up to 30 seconds
- (+) reproduction of symptoms
63
Q
phalen’s
A
- CTS - median nerve
- pt seated
- ask pt to fully flex both wrists, backs of hands together for up to 60s
- (+) reproduction of numbness or paresthesias in median nerve distribution
64
Q
carpal compression test
A
- CTS - median nerve
- pt seated, arm on table, palm up
- apply even, constant pressure over CT to compress median nerve
- hold up to 30s
- (+) reproduction of median nerve symptoms
